Purpose: The purpose of this study was to compare the clinical performance of a polyacid modified resin composite and a nanocomposite applied with an antibacterial adhesive system over a period of 2 years in noncarious Class V lesions. Materials and Methods: Twenty-four patients with at least two noncarious cervical lesions were enrolled in the study. The teeth were restored with a polyacid modified resin composite (Dyract eXtra, Dentsply DeTrey) or a nanocomposite (Filtek Supreme, 3M/ESPE). Fifty restorations of each material were placed with no marginal bevels and no mechanical retentions using an antibacterial self-etching adhesive system (Clearfil Protect Bond, Kuraray). All lesions were evaluated at baseline, 6, 12, and 24 months periods using the USPHS criteria for color match, marginal discoloration, marginal adaptation, caries formation, anatomic form, postoperative sensitivity, surface roughness, and retention. The changes across the four time points were assessed using Friedman and Wilcoxon Signed Ranks tests. The two restorative materials were compared in the same recall period for each of the criteria using chi-square test (p = 0.05). Results: Dyract eXtra restorations exhibited a significantly better color match than Filtek Supreme restorations; however, all restorations in both groups were clinically acceptable. Filtek Supreme's retention rate (100%) was found to be significantly better than that of Dyract eXtra (96%). Two Dyract eXtra restorations were completely lost while one was partially fractured (p = 0.05). Significant differences were observed in marginal adaptation and color match of Filtek Supreme restorations and marginal discoloration of Dyract eXtra and Filtek Supreme restorations between the baseline and the 2-year scores (p = 0.05). Conclusion: Both restorative materials showed acceptable clinical performance in Class V noncarious lesions after 2 years of clinical service. Keywords: nanocomposite, polyacid modified resin composite, clinical trial, antibacterial adhesive, MDPB